Consultant radiologists are still deeply divided in their opinions about advanced practice, many still having concerns about clinical governance and the training and supervision needed. I have used a small questionnaire to obtain a 'snapshot' of breast screening units who use radiographer advanced practitioners, what they do, whether they replace or just augment the functions of a consultant radiologist, and the opinions of the radiologists working alongside them.

Advanced practice means more than just a means to enable second reading of films. Without continuous feedback, involvement in assessment and support, this can become a boring task, with skill levels and motivation difficult to sustain. Increasingly, in many units practitioners are replacing other aspects of the traditional role of the consultant radiologist. Almost all advanced practitioners are film readers, but many have extended their roles further and now also do stereo tactic biopsy, ultrasound and ultrasound-guided biopsy, clinical examination, and localisation of impalpable tumours. We need to encourage the many eligible units who could participate in the current trial of radiographer-only screen film reading to join, in order to provide concrete evidence that radiographers are as good as radiologists in real-life practice.

With consultant radiologist posts becoming a little easier to fill than previously, we need to examine this role more carefully and decide what benefits practitioners can bring to a unit, and how to make this role a fulfilling and secure one for our radiographers in the future.